Individual
SUSAN A BRANNON
Active
Individual
SUSAN A BRANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
14224
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000088077
—
AL
01
—
051088077
BCBS PROVIDER ID
AL
01
—
631214880
TAX ID
AL
Enumeration date
02/26/2007
Last updated
09/25/2014
Update your record
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